VIRGINIA EXCHANGE

The Virginia Insurance Exchange (Marketplace) is the Federally-Facilitated Marketplace.
The Federally-facilitated Marketplace is administered by the federal government, under the Department of Health and Human Services (HHS).

General information about the Federally-facilitated Marketplace can be found at: https://www.healthcare.gov/marketplace/individual/#state=virginia.

PATIENTS

The Federally-facilitated Marketplace is essentially a marketplace for individuals to shop for health insurance if they do not already have insurance coverage from another source. If individuals have insurance from another source such as employment, retirement benefits, or spousal benefits, they do not need to obtain it from the Marketplace.

HIV PROVIDERS

Providers must contract with each of the Qualified Health Plans offered in the marketplace individually to participate fully in the Federally-facilitated Marketplace.

This process is similar to enrolling in insurance or managed care organization provider networks. See below the list of insurers participating in the Federally-facilitated Marketplace, and information about contacting them.

As an HIV provider, you may qualify for designation as an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.

Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.

QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE

Below is a list of the Qualified Health Plans that have publically announced that they will offer plans in the Federally-facilitated Marketplace.
Wyoming has established Blue Cross Blue Shield of WY as the “benchmark” plan.
This list is being routinely updated, and may change as insurers join or drop out of the exchange. Please check back for updates.

Aetna
Plan Website: http://www.aetna.com/individuals-families/health-insurance-exchange.html
Provider Enrollment: http://www.aetna.com/healthcare-professionals/join-aetna-network/join-provider-network.html
Plan types offered: Individual

CareFirst BlueChoice, Inc.
Plan Website: https://member.carefirst.com/individuals/home.page
Provider Enrollment: https://provider.carefirst.com/wps/portal/Provider/Resources/Credentialing?WCM_GLOBAL_CONTEXT=/wcmwps/wcm/connect/Content-Provider/CareFirst/ProviderPortal/Credentialing/Tab/credProfOverview&WT.z_from=providerQuicklinks
Plan types offered: Individual

CareFirst BlueCross BlueShield
Plan Website: https://member.carefirst.com/individuals/home.page
Provider Enrollment: https://provider.carefirst.com/providers/home.page
Plan types offered: Individual

Coventry Healthcare of Virginia, Inc
Plan Website: http://chcvirginia.coventryhealthcare.com/services-and-support/index.htm
Provider Enrollment: http://chcvirginia.coventryhealthcare.com/services-and-support/providers/
Plan types offered: Individual

Group Hospitalization and Medical Services Inc.
Plan Website: https://carefirst.com/company/html/GroupHospitalizationMedicalServices.html
Provider Enrollment: http://www.premierhealthplan.org/Providers/
Plan types offered: SHOP

HealthKeepers, Inc.
Plan Website: http://www.premierhealthplan.org/Providers/
Provider Enrollment: http://www.anthem.com/home-providers.html
Plan types offered: Individual, SHOP

Innovation Health Insurance Company
Plan Website: http://www.innovation-health.com/
Provider Enrollment: http://www.innovation-health.com/signature-partners-provider-network/
Plan types offered: Individual

Kaiser Permanente
Plan Website: https://healthy.kaiserpermanente.org/html/kaiser/index.shtml?region=MID
Provider Enrollment: http://www.kaiserpermanentejobs.org/default.aspx
Plan types offered: Individual, SHOP

Optima Health
Plan Website: https://www.optimahealth.com/Pages/default.aspx
Provider Enrollment: http://providers.optimahealth.com/Pages/home-contact-us.aspx
Plan types offered: Individual, SHOP

Optima Health Plan
Plan Website: https://www.optimahealth.com/Pages/default.aspx
Provider Enrollment: http://providers.optimahealth.com/Pages/home-contact-us.aspx
Plan types offered: SHOP

Piedmont Community HealthCare, Inc.
Plan Website: http://www.pchp.net/
Provider Enrollment: http://www.pchp.net/index.php/commercial-contact-us.html
Plan types offered: Individual

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